2 Definitions of Quality ISO "Degree to which a set of inherent characteristic fulfills requirements"Six Sigma - "Uniformity around a target value"Philip B. Crosby - "Conformance to requirements".Joseph M. Juran - "Fitness for use". Fitness is defined by the customer.Noriaki Kano - A two-dimensional model of quality. The quality has two dimensions: "must-be quality" and "attractive quality".
3 What Is Quality? W. Edwards Deming: Meeting customer needs + wants = qualityQuality improves products/services and processesImproved products/services and processes = profitability
4 What Is Quality? American Society for Quality A subjective term for which each person has his or her own definition. In technical usage, quality can have two meanings:The characteristics of a product or service that bear on its ability to satisfy stated or implied needsA product or service free of deficienciesThe quality of a product or service refers to the perception of the degree to which the product or service meets the customer's expectations. Quality
5 What Is Quality?Today the most progressive view of quality is that it is defined entirely by the customer or end user and is based upon that person's evaluation of his or her entire customer/client experience.The client experience is the aggregate of all the touch points that clients have with the department’s products and services, and is by definition a combination of these.
6 Benefits of Quality Tangible Intangible Increase in services Decrease in wasteIncrease in productivityIntangibleCustomer/Client goodwillAlignment across department activities
7 Benefits of Quality to Employees Pride in services deliveredJob satisfactionImproved communicationsStreamlined work processesHappier clientsStrong client relationships
8 Benefits of Quality to the Department Improved quality of servicesClient oriented employeesImproved client relationsLower costsImproved community relations = better political relationsAbility to expand servicesImproved funding
9 Benefits of Quality to the Client Improved quality of servicesClient oriented employeesFriendlier atmosphereImproved choicesExpectations met or exceeded
11 QA and QCQuality Assurance which is the "prevention of defects", such as the deployment of a Quality Management System and preventative activities like Failure Mode & Effects Analysis.Quality Control which is the "detection of defects", most commonly associated with testing which takes place within a Quality Management System typically referred to as Verification and Validation.
12 “Big QI” and “little qi” Juran’s Quality HandbookJuran and Gryna 5th edition
13 21st Century Definition"The "total" in total quality indicates a concern for quality in the broadest sense - what has come to be known as the "Big Q". Big Q refers to quality of products, services, people, processes, and environments. Correspondingly, "Little q" refers to a narrower concern that focuses on the quality of one of these elements or individual quality criteria within an individual element."Reference: David L. Goetsch and Stanley B. Davis; Quality Management, Introduction to Total Quality management for Production, Processing, and Services, 3rd edition, Prentice Hall 2000
14 Contrast: little q Big Q Topic:ProductsProcessesFunctionsQuality is viewed as:CustomerAll products, goods, and services, whether used for community support or notAll processes; administrative, support, clinical, business, etc.All functions; planning, service, administration, finance, etc., whether for community or required by regulatory body.A systemic or global problemAll who are affected by the activities of public health; external and internalServices provided to intended recipientsProcesses directly related to delivery of services to clientsDirect client and community supportA local, county or state problemClients who receive value from services
15 Contrast: little q Big Q Topic:How to think about QualityQuality goals are included:Cost of poor qualityEvaluation of quality is based mainly on:Based on the global approach to healthy communitiesIn global preventive health planningAll costs that would disappear if all health conditions were perfectResponsiveness to citizen and stakeholder needsBased on culture of functional departmentsAmong goalsCosts associated with failure to meet public health needsConformance to regulatory specifications, procedures, standards
16 Big QI and little qiBig QI - managing for quality in all business processes and serviceslittle qi - managing for quality in a limited capacity—traditionally only in services and processes – narrow focus
17 Total Quality Management A management approach that originated in the 1950's and became more popular during the early 1980's.Total Quality is a description of the culture, attitude and organization of a company that strives to provide customers with products and services that satisfy their needs.The culture requires quality in all aspects of the organization's operations, with processes being done right the first time and defects and waste eradicated from operations.
18 Team DiscoveryRate your own department on the following Big QI and little qi attributesForm into teams. Half the teams do Big QI and half do little qi rankings on the attributes
19 8 Quality Attributes of “Big QI” Customer focusOrganizations depend on their customers and therefore should understand current and future customer needs, should meet customer requirements, and strive to exceed customer expectations.LeadershipLeaders establish unity of purpose and direction of the organization. They should create and maintain the internal environment in which people can become fully involved in achieving the organization’s objectives.Involvement of peoplePeople at all levels are the essence of an organization, and their full involvement enables their abilities to be used for the organization’s benefit.Process approachA desired result is achieved more efficiently when activities and related resources are managed as a process.
20 8 Quality Attributes of “Big QI” System approach to managementIdentifying, understanding, and managing interrelated processes as a system contributes to the organization’s effectiveness and efficiency in achieving its objectives.Continual improvementContinual improvement of the organization’s overall performance should be a permanent objective of the organization.Factual approach to decision makingEffective decisions are based on the analysis of data and information.Mutually beneficial supplier relationshipsAn organization and its suppliers are interdependent, and a mutually beneficial relationship enhances the ability of both to create value.
21 8 Quality Attributes of “little qi” Clear DirectionSenior management has proved clear direction as to the importance of quality improvementProcess OrientationProcess oriented quality improvementTrainingOrganization has provided quality improvement training for all levels of the organizationAccountabilityProcess owners accept accountability for their process’s success
22 8 Quality Attributes of “little qi” MetricsOrganization is data driven in all its decision makingResponsibilityQuality improvement is delegated to those closest to the specific processesBuy-InAll employees participate and have a positive attitude towards quality improvementDaily ManagementEmployees utilize quality improvement tools and techniques in their daily work to make it more efficient, less costly, and customer/client focused
23 Rating Your Department The next two Radar Charts are designed to help rate our current state on the attributes of Big QI and little qi.For each score you give to an attribute, document “Why” it was given for future reference
24 Rating Your Department Rating Scale:0 – nothing in place1 – investigating/exploring2 – minimal/just starting3 – basics are in place4 – using it on selected improvement projects5 - department-wide use with good results
25 Rate Your Big QI Involvement CustomerFocusSupplierRelations5Leadership4321FactualApproachInvolvement ofPeopleProcessApproachContinuousImprovementSystemApproachRate Your Big QI Involvement
26 Rate Your little qi Involvement ClearDirectionDailyManagement5ProcessOrientation4321Buy-InTrainingAccountabilityResponsibilityMetricsRate Your little qi Involvement
27 Rating Your Department The rating on the attributes of “Big QI” and “little qi” give the department a chance to determine an action plan since it will have the areas highlighted where we are doing well and those areas needing improvement
28 Juran’s Quality Trilogy Quality Planning – build a capable systemQuality Control – identify where action is requiredQuality Improvement – better ways of doing things
29 Juran’s Quality Trilogy ControlHolding The GainsQualityPlanningParetoAnalysisBreakthroughQualityImprovementProject by Project
31 Deming Cycle – PDCA or PDSA PDCA was made popular by Dr. Deming who is considered by many to be the father of modern quality control; however it was always referred to by him as the "Shewhart cycle."
32 Deming Cycle – PDCA or PDSA PDCA should be repeatedly implemented in spirals of increasing knowledge of the system that converge on the ultimate goal, each cycle closer than the previous.The power of Deming's cycle lies in its apparent simplicity.
34 Continuous Improvement The continuous improvementphase of a process is how youmake a change in direction.The change usually is becausethe process output is deteriorating or client needs have changed
35 PDCA PLAN Plan ahead for change Creation of the implementation team Measurements to show improvementAction plans to detail what will be done by who and whenCommunication plan to inform needed parties of the changes, timing, and status
36 PDCADOImplement the process improvement initiative - taking small steps in controlled circumstancesGet sponsors approval and their support if implementing means going outside your personal area of responsibilityDocument the changes so the process can be duplicated/standardized
37 PDCACHECK:Continually check the results as the process is initiated and after it is in place to determine if the changes are meeting requirementsDetermine if the measurements used to determine success are adequateIf not, define the required measurements and how this data can be developedRemember to automate data gathering if at all possible
38 PDCA ACT: Take action to standardize or improve the process If the process changes are meeting requirements continue to monitor occasionallyStandardize the changes – SDCA CycleIf the process still isn’t meeting requirements investigate additional process improvement opportunities
39 Maintenance and Standardization The Maintenance andStandardization phase of aprocess is how we hold thegains. If our process is producing the desired results we standardizewhat we are doing.
40 Integrated Cycle The SDCA and PDCA cycles are separate but integrated. Once we have made a successful change we standardize and hold the gain. When the process is not performing correctly we go from SDCA to PDCA and once we have the process performing correctly we standardize again.This switching back and forth between SDCA and PDCA provides us with the opportunity to keep our process customer focused.
41 ImprovementRequiresChangeNeedsActionProcess Knowledge RequiresExperienced People